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Nordlander, M., Isaksson, U. & Hörnsten, Å. (2019). Perceptions of What Is Important for Appetite: An Interview Study With Older People Having Food Distribution. Sage Open Nursing, 5
Open this publication in new window or tab >>Perceptions of What Is Important for Appetite: An Interview Study With Older People Having Food Distribution
2019 (English)In: Sage Open Nursing, ISSN 2377-9608, Vol. 5Article in journal (Refereed) Published
Abstract [en]

The proportion of older people in the population increases and more and more continue living in their own homes. Appetite among the elderly people is important to their nutrition and health. The increased risk of unintended weight loss and malnutrition is linked to food distribution among home-living elderly people. The aim was to describe experiences and perceptions of what matters to appetite among home-living elderly people having food distribution. The design was qualitative where interview data were collected among 13 interviewees in 2017 to 2018. Data were analyzed using qualitative content analysis. The results are presented in three domains: the food, the meal situation, and the adaptation to meal service with categories and themes responding to each domain. The six themes related to appetite among the elderly people concerned the following: eating tasty, savory, and culturally adapted food; eating healthy and sustainable food; eating alone or together with others; eating in a pleasant meal environment; having choices to make about the meal; and last, accepting disabilities and increased dependency. One conclusion is that many aspects should be taken into consideration when promoting appetites of people who also get food distribution. It is highly individual and an understanding of which aspects are relevant must be considered; consequently, person-centered care is suggested to promote appetite.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
appetite, home-living elderly people, perceptions, food distribution, interviews, nursing
National Category
Nursing Nutrition and Dietetics
Identifiers
urn:nbn:se:umu:diva-156877 (URN)10.1177/2377960818817126 (DOI)000458647600001 ()
Available from: 2019-03-11 Created: 2019-03-11 Last updated: 2019-03-11Bibliographically approved
Öberg, U., Isaksson, U., Jutterström, L., Orre, C. & Hörnsten, Å. (2019). Person-Centered Interactive Self-Management Support in Primary Health Care for People with Type 2 Diabetes: Protocol for a Randomized Controlled Trial. JMIR Research Protocols, 8(4), Article ID e10250.
Open this publication in new window or tab >>Person-Centered Interactive Self-Management Support in Primary Health Care for People with Type 2 Diabetes: Protocol for a Randomized Controlled Trial
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2019 (English)In: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 8, no 4, article id e10250Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Type 2 diabetes (T2D) is increasing as the population ages. The development of new medical treatments is promising and important, but the basic treatment remains self-management, even if adherence to lifestyle advice is low. Electronic health (eHealth) or mHealth interventions can increase empowerment among people living with T2D and may compensate for the lack of professional resources and geographical distances. The interactive self-management support (iSMS) project aims at including digital tools to support people living with T2D in their self-management and facilitating their interaction with diabetes specialist nurses (DSNs). This protocol outlines a study with the purpose of developing and evaluating an intervention where people living with T2D can increase self-efficacy and empowerment through digital self-monitoring and interaction with DSNs.

OBJECTIVE: To develop and evaluate a person-centered iSMS intervention in primary health care for people with T2D in addition to their usual diabetes care.

METHODS: This study is a 12-month, 3-armed, nonblinded randomized controlled trial (RCT), which will be conducted in 6 primary health care centers (HCCs) in northern Sweden. Eligible participants will be randomized to either an intervention group (n=46), a control group (n=46), or an external group (n=46) for comparison. The intervention group will receive the mobile app, and the control group will receive a minimal intervention (diabetes brochure) and the usual standard of care. Changes in glycated hemoglobin (HbA1c) will be the primary outcome measure.

RESULTS: This trial is currently open for recruitment. The first results are expected to be submitted for publication in Autumn 2019.

CONCLUSIONS: This study, with its focus on iSMS, will provide insights regarding suitable ways to promote and develop a person-centered intervention. If successful, the intervention has the potential to become a model for the provision of self-management support to people with T2D.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/10250.

Place, publisher, year, edition, pages
JMIR Publications, 2019
Keywords
eHealth, internet, mobile apps, nurse specialists, primary health care, randomized controlled trial, self-management, type 2 diabetes
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-158655 (URN)10.2196/10250 (DOI)000466496800003 ()30958279 (PubMedID)
Funder
Swedish Diabetes Association
Available from: 2019-05-06 Created: 2019-05-06 Last updated: 2019-06-10Bibliographically approved
Öberg, U., Hörnsten, Å. & Isaksson, U. (2019). The Self‐Management Assessment Scale: development and psychometric testing of a screening instrument for person‐centred guidance and self‐management support. Nursing Open, 6, 504-513
Open this publication in new window or tab >>The Self‐Management Assessment Scale: development and psychometric testing of a screening instrument for person‐centred guidance and self‐management support
2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 6, p. 504-513Article in journal (Refereed) Published
Abstract [en]

Aim: To develop and psychometrically test the Self‐Management Assessment Scale (SMASc), a screening instrument for person‐centred guidance and self‐management support of persons with type 2 diabetes (T2D).

Background: T2D is a common and globally increasing chronic condition. Improved self‐management is a vital and integral component of diabetes care to prevent complications from poorly managed diabetes. For diabetes nurses to better understand persons with diabetes experienced challenges and needs regarding self‐management and further for persons with T2D to take an active role in managing their condition, an instrument measuring this is needed.

Design: Instrument development and psychometric testing of the content and construct validity, factor structure and reliability.

Method: The SMASc was psychometric tested on a sample of participants (September 2017–November 2017) with a confirmed diagnosis of T2D (N = 104).

Results: Psychometric findings were satisfactory and supported the scale´s reliability. Cronbach's alpha, CVI and goodness‐of‐fit were acceptable.

Conclusion: Self‐Management Assessment Scale is a short validated screening instrument, which can indicate possible barriers for self‐management that ought to be approached during the conversation between the person with T2D and the primary healthcare nurses. Therefore, it is a promising instrument to be used to facilitate person‐centred guidance and to improve self‐management of people living with T2D.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
instrument development, nursing, person‐centred care, psychometric properties, self‐management support, type 2 diabetes
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-155317 (URN)10.1002/nop2.233 (DOI)000461835600030 ()30918701 (PubMedID)
Funder
Swedish Diabetes Association
Available from: 2019-01-11 Created: 2019-01-11 Last updated: 2019-05-16Bibliographically approved
Olsson, K., Näslund, U., Nilsson, J. & Hörnsten, Å. (2018). Patients' experiences of the transcatheter aortic valve implantation trajectory: A grounded theory study. Nursing Open, 5(2), 149-157
Open this publication in new window or tab >>Patients' experiences of the transcatheter aortic valve implantation trajectory: A grounded theory study
2018 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 2, p. 149-157Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to explore how patients experienced the recovery process from transcatheter aortic valve implantation. Design: A qualitative approach where in-depth interviews were used. Method: Eleven men and eight women undergoing transcatheter aortic valve implantation were individually interviewed 6 months after transcatheter aortic valve implantation. Grounded theory was used for the analysis. Results: The analysis generated the core concept "A journey of balancing between life-struggle and hope" connected to descriptive, bipolar categories. Before transcatheter aortic valve implantation patients not only felt threatened but also experienced hope. The rehabilitation phase was described as demanding or surprisingly simple. At the 6 months follow-up patients were pleased to return to life, however, still struggling with limitations. To feel hope is essential for transcatheter aortic valve implantation patients' well-being, both before and during the recovery process. It is important that healthcare professionals not only support hopeful thinking but also take time to discuss and prepare patients, talk about concerns and build confidence. Individual plans for rehabilitation should be designed.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2018
Keywords
aortic stenosis, coping, hope, qualitative study, recovery, supportive nursing, transcatheter aortic valve implantation
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-148639 (URN)10.1002/nop2.124 (DOI)000428455600006 ()29599990 (PubMedID)
Available from: 2018-06-25 Created: 2018-06-25 Last updated: 2018-06-25Bibliographically approved
Öberg, U., Isaksson, U., Jutterström, L., Orre, C.-J. & Hörnsten, Å. (2018). Perceptions of Persons With Type 2 Diabetes Treated in Swedish Primary Health Care: Qualitative Study on Using eHealth Services for Self-Management Support. JMIR Diabetes, 3(1), Article ID e7.
Open this publication in new window or tab >>Perceptions of Persons With Type 2 Diabetes Treated in Swedish Primary Health Care: Qualitative Study on Using eHealth Services for Self-Management Support
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2018 (English)In: JMIR Diabetes, ISSN 2371-4379, Vol. 3, no 1, article id e7Article in journal (Refereed) Published
Abstract [en]

Background: Digital health services are increasing rapidly worldwide. Strategies to involve patients in self-monitoring of type 2 diabetes (T2D) on a daily basis is of crucial importance, and there is a need to optimize the delivery of care such as self-management support. Digitalized solutions have the potential to modify and personalize the way in which people use primary health services, both by increasing access to information and providing other forms of support at a distance. It is a challenge to integrate core values of person-centered care into digitalized health care services.

Objective: The objective of this study was to describe perceptions of using electronic health (eHealth) services and related technologies for self-management support among people with T2D treated in Swedish primary health care.

Methods: This is a qualitative study based on interviews analyzed using qualitative content analysis conducted among people diagnosed with T2D.

Results: Findings suggest that the participants had mixed feelings regarding the use of digital health services for self-management support. They experienced potentials such as increased involvement, empowerment, and security, as well as concerns such as ambivalence and uncertainty.

Conclusions: Digital health services for self-management are easily accessible and have the potential to reach a wide population. However, targeted training to increase digital skills is required, and personalized devices must be adapted and become more person-centered to improve patients’ involvement in their own care.

Place, publisher, year, edition, pages
JMIR Publications, 2018
Keywords
eHealth, internet, type 2 diabetes, self-management, primary health care, qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-145997 (URN)10.2196/diabetes.9059 (DOI)30291075 (PubMedID)2-s2.0-85047781902 (Scopus ID)
Available from: 2018-03-26 Created: 2018-03-26 Last updated: 2019-05-16Bibliographically approved
Öberg, U., Orre, C.-J., Isaksson, U., Schimmer, R., Larsson, H. & Hörnsten, Å. (2018). Swedish primary healthcare nurses' perceptions of using digital eHealth services in support of patient self-management. Scandinavian Journal of Caring Sciences, 32(2), 961-970
Open this publication in new window or tab >>Swedish primary healthcare nurses' perceptions of using digital eHealth services in support of patient self-management
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2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 961-970Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Nurses have expressed doubts about the ongoing digitalisation of Swedish primary health care. Given the potential role of eHealth in primary health care, including supporting interactive self-management for people with chronic conditions, it is important to highlight nurses' experiences. This study is part of a larger project aimed at implementing person-centred interactive self-management support (iSMS) in primary health care.

AIM: The aim of this study was to describe Swedish primary healthcare nurses' perceptions of using digital eHealth systems and services to support patient self-management.

METHODS: Focus group interviews were conducted with primary healthcare nurses (n = 20). The interview transcriptions were analysed using qualitative content analysis.

RESULTS: Three themes emerged from the content analysis: caregiving in the midst of digital chaos; a lack of overview and control in daily work; and mixed feelings towards digitalisation. Each theme was subdivided into three subthemes.

CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE: The results of this study provide insight into a number of concerns that stand in the way of success when it comes to the implementation and use of digital technology. If nurses are to adapt to the new policies and practices that accompany the current digitalised development in Swedish primary health care, the concept of a nurse's traditional work role needs to be amended in terms of the scope of work tasks and established views of traditional nursing. The study also highlights the need for more research to enable eHealth systems/services to be designed to fulfil multiple requirements. The digitised systems should be a tool for achieving good quality self-management support as well as giving the primary healthcare nurses adequate resources to support patients' self-management while still maintaining the values associated with person-centred care.

Keywords
chronic conditions, eHealth, nurses, primary health care, self-management, technology, type 2 diabetes
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-145996 (URN)10.1111/scs.12534 (DOI)000436254800053 ()28960451 (PubMedID)
Available from: 2018-03-26 Created: 2018-03-26 Last updated: 2019-05-16Bibliographically approved
Hultstrand Ahlin, C., Hörnsten, Å., Coe, A.-B., Lilja, M. & Hajdarevic, S. (2018). Wishing to be perceived as a capable and resourceful person: A qualitative study of melanoma patients’ experiences of the contact and interaction with healthcare professionals. Journal of Clinical Nursing, 28(7–8), 1223-1232
Open this publication in new window or tab >>Wishing to be perceived as a capable and resourceful person: A qualitative study of melanoma patients’ experiences of the contact and interaction with healthcare professionals
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2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 7–8, p. 1223-1232Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: To explore patients' experiences of contact and interaction with healthcare professionals (HCPs) during the diagnostic process of melanoma.

BACKGROUND: In Sweden, most patients with suspected skin lesions seek care at the primary level of services in the first instance. Previous research describes the diagnostic process as a complex journey with uncertainty. Nonetheless, the importance of contact and interaction between patient and HCPs during the diagnostic process is rarely explored.

DESIGN: This study adopted a qualitative design in which semi-structured interviews were conducted and the COREQ-checklist for qualitative studies employed (EQUATOR guidelines).

METHODS: A sample of 30 patients (15 women, 15 men) diagnosed with melanoma was included. Secondary analysis of interviews was carried out using qualitative content analysis.

RESULTS: One theme emerged: Wishing to be perceived as a capable and resourceful person that consisted of three categories: (a) The need of being valued, (b) The need of being informed and (c) The need of taking actions.

CONCLUSIONS: Our results suggest that patients wish to be valued as capable and resourceful persons as well as to be provided with honest and sufficient information about the diagnosis and subsequent procedures. By fulfilling these wishes, HCPs can involve patients in the diagnostic process and reduce patients' uncertainty. A need of supportive and accessible health care to manage the diagnostic process and to reduce patients' struggle for care was also identified.

RELEVANCE TO THE CLINICAL PRACTICE: Patients are satisfied when health care is organised in a patient-/person-centred manner, that is, in accordance with patients' needs, avoiding gatekeeping, and when HCPs interact respectfully in encounters. Accessible HCPs during the diagnostic process of melanoma are required to inform, support and navigate patients within the healthcare system and through their diagnostic journey.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
cancer, care needs, healthcare professional-patient relationship, patient-centred care, patients’ experience, qualitative study
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-155315 (URN)10.1111/jocn.14730 (DOI)000460767400018 ()30549354 (PubMedID)2-s2.0-85059608526 (Scopus ID)
Available from: 2019-01-11 Created: 2019-01-11 Last updated: 2019-05-06Bibliographically approved
Andertun, S., Hörnsten, Å. & Hajdarevic, S. (2017). Ebola virus disease: caring for patients in Sierra Leone - a qualitative study. Journal of Advanced Nursing, 73(3), 643-652
Open this publication in new window or tab >>Ebola virus disease: caring for patients in Sierra Leone - a qualitative study
2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 3, p. 643-652Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study was to describe Norwegian healthcare staffs' experiences of participating in care of patients with Ebola virus disease in Sierra Leone.

BACKGROUND: Ebola is one of the most feared viruses known. Ebola virus disease is highly contagious with high mortality. The few qualitative studies made on experiences among healthcare professionals have highlighted problems as lack of protective resources, insufficient personnel and risk of societal stigmatization.

DESIGN: Descriptive study with qualitative approach.

METHOD: Individual narrative and focus group interviews were obtained during 2015 with eight nurses and one physician who had worked in Ebola care in Sierra Leone. The interviews were analysed using qualitative content analysis.

RESULT: The analysis resulted in the two themes: 'Experiencing security by learning to manage risks'; and 'Developing courage and growth by facing personal fears'. Subthemes were: 'Relying on safeguard actions', 'Managing risk of contagion', 'Developing strategies for care despite risks', 'Constantly reminded of death', 'Successively defeating fears' and last, 'Increasing motivation through meaningfulness'. The participants described the reliance on training, organized effort, strict guidelines and equipment. They were respectful of the risk of transmission, made risk assessments, took responsibility, handled risky situations and were reminded of suffering and death.

CONCLUSION: Despite challenges, the hazardous work with Ebola virus disease patients was experienced as meaningful which was an important motivator. Safe care was central in working with Ebola patients, but the care relation was challenged.

Keywords
Ebola, Sierra Leone, care relation, experiences, healthcare professionals, nursing, qualitative design, risk, safety
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-127092 (URN)10.1111/jan.13167 (DOI)000399292400011 ()27747916 (PubMedID)
Available from: 2016-10-28 Created: 2016-10-28 Last updated: 2018-06-09Bibliographically approved
Oftedal, B., Kolltveit, B.-C. H., Zoffmann, V., Hörnsten, Å. & Graue, M. (2017). Learning to practise the Guided Self-Determination approach in type 2 diabetes in primary care: A qualitative pilot study. Nursing Open, 4(3), 134-142
Open this publication in new window or tab >>Learning to practise the Guided Self-Determination approach in type 2 diabetes in primary care: A qualitative pilot study
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2017 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 4, no 3, p. 134-142Article in journal (Refereed) Published
Abstract [en]

Aim: To describe how diabetes nurses in primary care experience the process of learning to practise the person-centred counselling approach Guided Self-Determination among adults with type 2 diabetes. Design: A descriptive qualitative design. Method: Data were collected in 2014-2015 by means of individual interviews with four diabetes nurses at two points in time. The data were analysed using qualitative content analysis. Results: Three themes that reflect nurses' processes in learning to use the Guided Self-Determination approach were identified: (1) from an unfamiliar interaction to cracking the code; (2) from an unspecific approach to a structured, reflective, but demanding approach; and (3) from a nurse-centred to a patient-centred approach. The overall findings indicate that the process of learning to practise Guided Self-Determination increased the nurses' counselling competence. Moreover, the nurses perceived the approach to be generally helpful, as it stimulated reflections about diabetes management and about their own counselling practices.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-138547 (URN)10.1002/nop2.76 (DOI)000405085600003 ()28694977 (PubMedID)
Available from: 2017-09-14 Created: 2017-09-14 Last updated: 2018-06-09Bibliographically approved
Wennberg, A.-L., Jonsson, S., Zadik Janke, J. & Hörnsten, Å. (2017). Online Perceptions of Mothers About Breastfeeding and Introducing Formula: Qualitative Study. JMIR public health and surveillance, 3(4), Article ID e88.
Open this publication in new window or tab >>Online Perceptions of Mothers About Breastfeeding and Introducing Formula: Qualitative Study
2017 (English)In: JMIR public health and surveillance, ISSN 2369-2960, Vol. 3, no 4, article id e88Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Although the benefits of breastfeeding are well established for babies and their mothers, many women give formula to their infants. Whether to breastfeed or to give infant formula is a complex decision to make. Many parents use the Internet to find information and support that relate to infant feeding decisions.

OBJECTIVE: The aim of this study was to analyze the perceptions of mothers, who are discussing the topic on Web forums, about introducing infant formula.

METHODS: This is a qualitative, descriptive, and cross-sectional study on online data from parenting Web forums. The text was analyzed using qualitative content analysis.

RESULTS: The analysis resulted in 1 main theme, "balancing between social expectations and confidence in your parental ability," which is further divided into 3 themes: "striving to be a good mother," "striving for your own well-being," and "striving to discover your own path."

CONCLUSIONS: Breastfeeding is complex, and health care personnel can, with a more open approach toward formula, create better support for mothers by helping them to be more confident in their parental ability.

Place, publisher, year, edition, pages
JMIR Publications, 2017
Keywords
Internet, bottle feeding, breast feeding, decision making, mothers, patient web portals
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-158404 (URN)10.2196/publichealth.8197 (DOI)29141838 (PubMedID)
Available from: 2019-04-26 Created: 2019-04-26 Last updated: 2019-04-29Bibliographically approved
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